Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials

<h3>Objectives</h3><p dir="ltr">Robotic knee arthroplasty procedures have emerged as a new trend, garnering attention from orthopedic surgeons globally. It has been hypothesized that the use of robotics enhances the accuracy of prosthesis positioning and alignment restora...

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Main Author: Reda Alrajeb (17773221) (author)
Other Authors: Mohammed Zarti (17773224) (author), Zakaria Shuia (17773227) (author), Osama Alzobi (14150292) (author), Ghalib Ahmed (14146800) (author), Aissam Elmhiregh (14150667) (author)
Published: 2023
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_version_ 1864513521153212416
author Reda Alrajeb (17773221)
author2 Mohammed Zarti (17773224)
Zakaria Shuia (17773227)
Osama Alzobi (14150292)
Ghalib Ahmed (14146800)
Aissam Elmhiregh (14150667)
author2_role author
author
author
author
author
author_facet Reda Alrajeb (17773221)
Mohammed Zarti (17773224)
Zakaria Shuia (17773227)
Osama Alzobi (14150292)
Ghalib Ahmed (14146800)
Aissam Elmhiregh (14150667)
author_role author
dc.creator.none.fl_str_mv Reda Alrajeb (17773221)
Mohammed Zarti (17773224)
Zakaria Shuia (17773227)
Osama Alzobi (14150292)
Ghalib Ahmed (14146800)
Aissam Elmhiregh (14150667)
dc.date.none.fl_str_mv 2023-12-22T03:00:00Z
dc.identifier.none.fl_str_mv 10.1007/s00590-023-03798-2
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Robotic-assisted_versus_conventional_total_knee_arthroplasty_a_systematic_review_and_meta-analysis_of_randomized_controlled_trials/24980844
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
Total knee arthroplasty
Robotic arthroplasty
Jig-based arthroplasty
Conventional knee arthroplasty
dc.title.none.fl_str_mv Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Objectives</h3><p dir="ltr">Robotic knee arthroplasty procedures have emerged as a new trend, garnering attention from orthopedic surgeons globally. It has been hypothesized that the use of robotics enhances the accuracy of prosthesis positioning and alignment restoration. The objective of this study was to provide a high-level, evidence-based comparison between robotic total knee replacements and conventional methods, focusing on radiological and functional outcomes.</p><h3>Methods</h3><p dir="ltr">We searched five databases from their inception until June 1, 2022, specifically targeting randomized controlled trials (RCTs) that compared the outcomes of robotic and conventional total knee replacements. We were interested in outcomes such as knee range of motion, clinical and function knee society scores, the Western Ontario and McMaster University score (WOMAC), the Hospital of Special Surgery score, complications, and radiological alignment. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. We assessed the risk of bias using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2).</p><h3>Results</h3><p dir="ltr">Our search returned seven RCTs suitable for our analysis, which included a total of 1942 knees; 974 of these knees were implanted using robotic arms while the remaining 968 utilized jig-based knee systems. Our findings indicated that robotic knees had significantly better post-operative anatomical (OR − 0.82; 95% CI, − 1.027 to − 0.58, p value < 0.00001) and mechanical restoration (OR − 0.95; 95% CI, − 1.49 to − 0.41, p value < 0.0006). While knee range of motion (OR − 2.23; 95% CI − 4.89–0.43, p value 0.1) and femoral prosthesis position (OR − 0.98; 95% CI, − 2.03–0.08, p value 0.07) also favored robotic knees, these differences did not reach statistical significance. Both clinical and functional outcomes, as well as the rate of complications, were found to be statistically similar between the groups undergoing robotic and traditional knee replacement surgeries.</p><h3>Conclusion</h3><p dir="ltr">This meta-analysis indicates that robotic total knee replacements offer superior post-operative anatomical and mechanical alignment compared to conventional total knee replacements. Despite this, clinical and functional outcomes, as well as complication rates, were similar between the two. These findings should be considered in light of potential confounding factors. More randomized controlled trials with the latest robotic systems are needed to confirm any superior functional and clinical outcomes from robotic-assisted surgeries.</p><h3>Level of evidence</h3><p dir="ltr">I.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Orthopaedic Surgery & Traumatology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00590-023-03798-2" target="_blank">https://dx.doi.org/10.1007/s00590-023-03798-2</a></p><p dir="ltr">Additional institutions affiliated with: Surgical Specialty Center - HMC</p>
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identifier_str_mv 10.1007/s00590-023-03798-2
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/24980844
publishDate 2023
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rights_invalid_str_mv CC BY 4.0
spelling Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trialsReda Alrajeb (17773221)Mohammed Zarti (17773224)Zakaria Shuia (17773227)Osama Alzobi (14150292)Ghalib Ahmed (14146800)Aissam Elmhiregh (14150667)Biomedical and clinical sciencesClinical sciencesMathematical sciencesStatisticsTotal knee arthroplastyRobotic arthroplastyJig-based arthroplastyConventional knee arthroplasty<h3>Objectives</h3><p dir="ltr">Robotic knee arthroplasty procedures have emerged as a new trend, garnering attention from orthopedic surgeons globally. It has been hypothesized that the use of robotics enhances the accuracy of prosthesis positioning and alignment restoration. The objective of this study was to provide a high-level, evidence-based comparison between robotic total knee replacements and conventional methods, focusing on radiological and functional outcomes.</p><h3>Methods</h3><p dir="ltr">We searched five databases from their inception until June 1, 2022, specifically targeting randomized controlled trials (RCTs) that compared the outcomes of robotic and conventional total knee replacements. We were interested in outcomes such as knee range of motion, clinical and function knee society scores, the Western Ontario and McMaster University score (WOMAC), the Hospital of Special Surgery score, complications, and radiological alignment. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. We assessed the risk of bias using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2).</p><h3>Results</h3><p dir="ltr">Our search returned seven RCTs suitable for our analysis, which included a total of 1942 knees; 974 of these knees were implanted using robotic arms while the remaining 968 utilized jig-based knee systems. Our findings indicated that robotic knees had significantly better post-operative anatomical (OR − 0.82; 95% CI, − 1.027 to − 0.58, p value < 0.00001) and mechanical restoration (OR − 0.95; 95% CI, − 1.49 to − 0.41, p value < 0.0006). While knee range of motion (OR − 2.23; 95% CI − 4.89–0.43, p value 0.1) and femoral prosthesis position (OR − 0.98; 95% CI, − 2.03–0.08, p value 0.07) also favored robotic knees, these differences did not reach statistical significance. Both clinical and functional outcomes, as well as the rate of complications, were found to be statistically similar between the groups undergoing robotic and traditional knee replacement surgeries.</p><h3>Conclusion</h3><p dir="ltr">This meta-analysis indicates that robotic total knee replacements offer superior post-operative anatomical and mechanical alignment compared to conventional total knee replacements. Despite this, clinical and functional outcomes, as well as complication rates, were similar between the two. These findings should be considered in light of potential confounding factors. More randomized controlled trials with the latest robotic systems are needed to confirm any superior functional and clinical outcomes from robotic-assisted surgeries.</p><h3>Level of evidence</h3><p dir="ltr">I.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Orthopaedic Surgery & Traumatology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00590-023-03798-2" target="_blank">https://dx.doi.org/10.1007/s00590-023-03798-2</a></p><p dir="ltr">Additional institutions affiliated with: Surgical Specialty Center - HMC</p>2023-12-22T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s00590-023-03798-2https://figshare.com/articles/journal_contribution/Robotic-assisted_versus_conventional_total_knee_arthroplasty_a_systematic_review_and_meta-analysis_of_randomized_controlled_trials/24980844CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/249808442023-12-22T03:00:00Z
spellingShingle Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
Reda Alrajeb (17773221)
Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
Total knee arthroplasty
Robotic arthroplasty
Jig-based arthroplasty
Conventional knee arthroplasty
status_str publishedVersion
title Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
title_full Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
title_short Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
title_sort Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials
topic Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
Total knee arthroplasty
Robotic arthroplasty
Jig-based arthroplasty
Conventional knee arthroplasty